History of decompression sickness (DCS) with cerebral, spinal, inner ear or skin manifestations

Any history of migraine with aura

History of cryptogenic stroke

Family history of PFO or atrial septal defect (ASD) in first-degree relatives

The recommendations than continue to points 3 – 8 with a prescription of optimal testing procedures and criteria for evaluations of findings. Since the devil is in the details, we will wait for a final edition of the SPUMS position statement. The position paper brings a significant change in comparison to a current prevailing position of leading diving medicine experts in the United States. SPUMS usually has a disproportionately large following in the world and it may cause opinion makers in the United States to reconsider their position.